It’s unclear when the swelling started. Some reports say it was 18 months ago. Others say four months. But there’s agreement when it got really bad — when the growth had puffed his right cheek out like a chipmunk, when Ashik Gavai’s parents realized they needed to get him to a doctor, when some thought he had cancer.

When the 17-year-old got to Mumbai’s JJ Hospital, the family learned the boy’s growth wasn’t cancer. It was a tumor — but a very peculiar, rarely-seen one.

Gavai had been suffering from a condition called composite odontoma, which can foster a slow-growth tumor inside the jaw capable of birthing additional teeth-like structures. In Gavai’s case, he had a lot of them. There were at least 232 in his jaw, doctors say, calling it a “world record,” according to the BBC.

“It wasn’t cancer at all, it was a benign tumor,” the operating doctor, Sudanda Dhiware, who heads the hospital’s dentistry department, told The Washington Post in a phone interview. She said his molar tooth in the lower jaw had spawned hundreds of tiny teeth. “I have never seen anything like it in all my years of practice,” she added. “We were so excited by it. And it was really fun for us to be able to extract them all, one by one.”

Garvai comes from a poor family of cotton growers living in a village hours from Mumbai, though, reports again differed on its exact location. When the growth began, local doctors at that village couldn’t figure it out, even as it slowly began to cause severe pain and dominate the boy’s appearance.

“I was worried that it may turn out to be cancer, so I brought him to Mumbai,” the boy’s father told the Mumbai Mirror. But they didn’t have much money, so earlier this month they went to the state-run JJ Hospital. “We could not understand what was wrong with my son,” he added.

Three weeks passed. Then on Monday of this week, after the family secured treatment through a program that funds care for poor patients, the boy went under the knife.

The surgery took six hours, and soon doctors were removing so many teeth, the Mirror said, they lost count.

“At first, we couldn’t cut it out so we had to use the basic chisel and hammer to take it out,” Dhiware told the BBC. “Once we opened it, little pearl-like teeth started coming out, one by one. Initially, we were collecting them; they really were like small white pearls. But then, we started to get tired. We counted 232 teeth.”

According to a study on the matter in the International Journal of Clinical Pediatric Dentistry, the condition of composite odontoma is characterized by an “eruption of the teeth.” It says during the tumor’s development, “enamel and dentin can be deposited in such a way that the resulting structures show an anatomic similarity to normal teeth…”

But doctors at the Mumbai hospital said they’ve never known a tumor to produce this many teeth. “According to medical literature available on the condition, it is known to affect the upper jaw and a maximum of 37 teeth have been extracted from the tumor in the past,” Dhiware explained to the BBC. “But in Ashiq’s case, the tumor was found deep in the lower jaw and it had hundreds of teeth.”

Now, following the procedure, he has 28.

“He is under medication right now,” Dhiware told the Post. “It was a benign tumor and we have tried our best to take out everything. But you never know if there’s something microscopic left, and it could come back.”